Evaluation of Pelvic Floor Muscle Strength and Anal Spinchter Defects in Women Post Repair Obstetric Anal Spinchter Injuries

Abstract

Tujuan: penelitian ini bertujuan untuk mengevaluasi defek sfingter ani dan disfungsi otot dasar panggul pada perempuan pasca repair trauma sfingter ani obstetri.
Metode: Analitik observasional yang dikembangkan dengan desain kohort prospektif. Perempuan yang mengalami Repair Trauma Sfingter Ani Obstetri pada Bulan Januari 2020-Juni 2021 di beberapa RS jejaring Makassar dinilai defek pasca repair dan keluhan subjektif menggunakan USG Transperineal (Alpinion cube 5 dengan probe transvaginal), Skor Wexner, Numeric Pain Rating Scale dan Perineometer (Peritron 9300 V) yang dilakukan dalam 3 kali pengukuran yaitu pada bulan 1, 3 dan 6 pasca repair. Data diuji menggunakan Mann-Whitney test, Cochrane dan Independent T test. Data diolah menggunakan SPSS 24.
Hasil: Dari 51 sampel yang dilakukan pemeriksaan, didapatkan rata-rata usia 27.82±4.04 tahun dengan rerata IMT 24.52±4.31 kg/m2. Sampel didominasi oleh primipara sebanyak 41(80,4%). Rerata berat bayi 3312.75±424.24 gram. Terdapat 5 (9,8%) Pasien yang mengalami defek pasca repair, rerata skor wexner pada sampel dengan defek sfingter ani 1.60±1.14 pada bulan pertama, terdapat perbedaan yang signifikan pada dispareunia (p<0.05) dengan rerata 3.33±1.15 pada sampel dengan defek sfingter ani pada bulan keenam. Tampak peningkatan rerata skor kekuatan otot panggul pada perempuan tanpa defek sfingter ani.
Kesimpulan: Gejala subjektif dapat ditemukan pada perempuan tanpa defek sfingter ani. Peningkatan kekuatan otot dasar panggul dapat terjadi seiring bertambahnya waktu pasca repair.

Evaluation of Pelvic Floor Muscle Strength and Anal Sphincter Defects in Post Obstetric Anal Sphincter Injuries Repair Women

Abstract
Objectives: The goal of this study was to look at anal sphincter deficiencies and pelvic floor muscle dysfunction in women who had obstetric anal sphincter injuries and had them repaired.
Methods: Analytical was created as an observational study with a cohort prospective design. Women who underwent OASIS Repair in multiple Makassar hospitals between January 2020 and June 2021 were assessed subjectively using Transperineal Ultrasound (Alpinion cube 5 ultrasound with transvaginal probe), Wexner Score, Numeric Pain Rating Scale, and Perineometer (Peritron 9300 V) at 1, 3, and 6 months after repairs. The data was analyzed using the Mann-Whitney test, Cochran test, and Independent T test in SPSS 24.
Result: The average age of the 51 samples that underwent the assessment was 27.82.04 years, with a mean BMI of 24.524.31 kg/m2. Up to 41 percent of the sample was dominated by primiparas (80.4 percent ). The average infant weighs 3312.75424.24 grams. There were 5 (9.8%) patients who had a defect after repair, with an average score of 1.601.14 on the first month and a significant difference in dyspareunia (p0.05) with a mean of 3.331.15 on the sixth month in the sample with anal sphincter defect. In women who do not have an anal sphincter dysfunction, there is an average increase in look strength of the pelvic muscle.
Conclusion: Women without an anal sphincter abnormality had subjective complaints. With more time passed after surgery, the pelvic floor muscle may improve.

Key words: pelvic floor, OASIS, Wexner score, Anal Sphincter defect, Transperineal ultrasound